Development in Norwegians' use of CAM, 2012-

How do Norwegians' use of complementary and alternative medicine (CAM) and dietary supplements develop over time? How is their health developing, and how do their costs for this develop? What differences can be seen between the most recent survey and the older ones? Do we see any patterns or trends?

This article provides answers to these questions, as they have been measured in NAFKAMs population survey every two years since 2012. Changes are presented in percentage points (pp), Norwegian kroner (NOK) and in percentage, expressing the differences between the most recent survey and the previous one; as well as between the newest and the oldest (2012).

The reports from each of the editions are publically available, and can be found here: 2022 - 2020 - 2018 - 2016 - 2014 - 2012.

You may also read our introductory article on the NAFKAM national survey in general, which outlines its methodology, structure etc.

What is measured? 

"Complementary and alternative medicine" (CAM) includes health-related treatment from a provider in line with the definition in §2 in the Norwegian  Act No 64 about complementary and alternative medicine; use of herbs/ natural remedies (plant-based drugs), and/or the use of self-help techniques. The term "treatment" also includes advice from a provider on diet/lifestyle changes, and/or guidance from instructors providing training in various self-help techniques for self-treatment and health-related purposes.

The use of dietary supplements is not initially considered CAM, but NAFKAM has a special sub-mission from the Norwegian health authorities to monitor and report the population's use of this as well. For practical reasons, we collect this at the same time as we investigate the use of CAM.

1. Introduction

The size and composition of the Norwegian population is yearly monitored by Statistics Norway. The gender-composition of NAFKAMs surveys aim to reflect this, on the basis of its 1,000 interviews of people aged 18 years or more:

Table 1.1: Development of the adult Norwegian population, versus NAFKAMs surveys

  2012 2014 2016 2018 2020 2022
Total population 18 yrs+ 3,867,645 3,983,895 4,086,583 4,166,612 4,248,972 4,316,747
% men 49,8% 50,0% 50,1% 50,1% 50,2% 50,2%
% women 50,2% 50,0% 49,9% 49,9% 49,8% 49,8%
% men in NAFKAM survey 48,3% 54,4% 52,7% 54,4% 52,0% 50,1%
% women in NAFKAM survey 51,7% 45,6% 47,3% 45,6% 48,0% 49,9%

1. Development of popuation's use of CAM and dietary supplements

Table 2.1: Usage, independent of gender 

% of all respondents 2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Total use of CAM 45,3% 41,0% 35,8% 36,5% 39,3% 38,3% -7,0 pp (-15,5%) -1,0 pp (-2,5%)
CAM treatment from providers 36,6% 30,9% 23,5% 22,4% 20,7% 24,9% -11,7 pp (-32,0%) +4,2 pp (+20,3%)
Herbs/ natural remedies (not supplements) 12,0% 10,7% 10,8% 9,6% 9,3% 13,8% +1,8 pp (+15,0%) +4,5 pp (+48,4%)
Self-help techniques 12,4% 14,4% 14,3% 16,9% 21,8% 18,1% +5,7 pp (+46,0%) -3,7 pp (-17,0%)
Supplements (not herbs) 70,4% 70,1% 66,0% 68,8% 70,9% 73,8% +3,4 pp (+4,8%) +2,9 pp (+4,1%)

Table 2.2: Usage among men

% of male respondents 2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Total use of CAM 36,3% 33,1% 27,1% 28,0% 30,7% 29,9% -6,4 pp (-17,6%) -0,8 pp (-2,5%)
CAM treatment from providers 27,1% 26,6% 18,3% 16,9% 15,5% 20,0% -7,2 pp (-26,4%) +4,4 pp (+28,4%)
Herbs/ natural remedies (not supplements) 9,4% 8,0% 7,7% 7,7% 8,8% 10,0% +0,6 pp (+6,1%) +1,2 pp (+13,0%)
Self-help techniques 7,0% 7,7% 6,5% 10,7% 15,4% 10,0% +3,0 pp (+42,5%) -5,4 pp (-35,0%)
Supplements (not herbs) 66,3% 65,5% 60,9% 62,5% 70,1% 69,9% +3,6 pp (+5,4%) -0,2 pp (-0,3%)

Table 2.3: Usage among women

% of female respondents 2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Total use of CAM 53,7% 50,5% 45,5% 46,8% 48,6% 46,7% -7,0 pp (-13,0%) -1,9 pp (-3,9%)
CAM treatment from providers 45,5% 36,1% 29,3% 29,1% 26,2% 29,9% -15,7 pp (-34,4%) +3,7 pp (+14,1%)
Herbs/ natural remedies (not supplements) 14,5% 13,9% 14,2% 11,9% 9,8% 17,6% +7,9 pp (+21,7%) +7,8 pp (+79,6%)
Self-help techniques 17,3% 22,4% 23,0% 24,4% 28,7% 26,3% +8,9 pp (+51,3%) -2,4 pp (-8,4%)
Supplements (not herbs) 74,3% 75,6% 71,8% 76,3% 71,7% 77,8% +3,5 pp (+4,7%) +6,1 pp (+8,5%)

3. How are the costs to CAM and supplements developing (NOK/ kr)?

Table 3.1: Average cost per user, independent of gender

Per user 2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Total use of CAM 2610 2409 2547 2970 2561 4718 +2108 kr (+80,8%) +2156 kr (+84,2%)
CAM treatment from providers 2498 2478 2738 3114 3770 4817 +2319 kr (+92,8%) +1047 kr (+27,8%)
Herbs/ natural remedies (not supplements) 688 1206 1446 995 1016 3386 +2698 kr (+392,1%) +2370 kr (+233,3%)
Self-help techniques 928 916 780 1733 535 1536 +608 kr (+65,5%) +1001 kr (+187,1)
Supplements (not herbs) 1167 964 931 1013 1038 1095 -72 kr (-6,2%) +57 kr (+5,5%)

Table 3.2: Men's costs

Per male user 2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Total use of CAM 2394 1753 1612 2159 2580 6967 +4573 kr (+191,0%) +4388 kr (+170,1%)
CAM treatment from providers 2565 1753 1701 2569 3898 2599 +34 kr (+1,3%) -1299 kr (-33,3%)
Herbs/ natural remedies (not supplements) 1701 1233 1449 1166 1332 5380 +3680 kr (+216,4%) +4048 kr (+303,1%)
Self-help techniques 440 654 284 814 363 526 +86 kr (+19,6%) +163 kr (+45,0%)
Supplements (not herbs) 1112 930 849 1038 1125 924 -188 kr (-16,9%) -201 kr (-17,9%)

Table 3.3: Women's costs

Per female user 2012 2014 2016 2018 2020 2022 Endringer, 2012-22 Endringer, 2020-22
Total use of CAM 2745 2926 3174 3561 2549 3682 +937 kr (+34,1%) +1133 kr (+44,5%)
CAM treatment from providers 2461 3094 3472 3491 3687 6324 +3863 kr (+156,9%) +2637 kr (+71,5%)
Herbs/ natural remedies (not supplements) 1346 1188 1499 862 806 2253 +906 kr (+67,3%) +1546 kr (+218,9%)
Self-help techniques 1142 1027 1000 2258 635 1921 +778 kr (+68,1%) +1286 kr (+202,6%)
Supplements (not herbs) 1214 1000 1075 989 945 1253 +39 kr (+3,2%) +307 kr (+32,5%)

4. How is the usage of CAM providers developing?

Table 4.1: Usage of predefined CAM therapies, among all respondents

CAM therapy name 2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Total use of CAM therapy from a provider 36,6% 30,9% 23,5% 22,4% 20,7% 24,9% -11,7 pp (-32,0%) +4,2 pp (+20,3%)
Acupuncture 9,9% 7,1% 5,5% 4,7% 4,8% 5,3% -4,6 pp (-46,4%) +0,5 pp (+10,4%)
Cupping - - 1,3% 0,5% 0,7% 1,5% - +0,8 pp (+114,3%)
Gestalt therapy - 0,2% - - - - - -
Homeopathy 3,0% 1,8% 0,9% 0,7% 0,4 1,3% -1,7 pp/ (-56,7%) +0,9 pp (+225%)
Kinesiology 1,7% 1,1% 0,7% 0,3% 0,4% - - -
Massage therapy 22,2% 20,3% 14,3% 14,1% 14,0% 17,4% -4,8 pp (-21,6%) +3,4 pp (+24,3%)
Naprapathy - 4,6% 2,7% 2,7% 2,9% 5,1% - +2,2 pp (+75,6%)
Naturopathy 2,0% - - - - - - -
Osteopathy - - 1,4% 1,1% 1,4% 3,4% - +2,0 pp (+143%)
Other CAM therapies (not on the list) 4,4% 4,0% 1,8% 1,7% 1,5% 0,9% -3,5 pp (-79,5%) -0,6 pp (-66,7%)
Psychotherapy (not from a psychologist/ psychiatrist) 2,0% - - - - 2,8% +0,8 pp (+40,0%) -
Reflexology 4,2% 3,1% 2,2% 1,2% 1,2% 1,7% -2,5 pp (-59,5%) +0,5 pp (+41,7%)
Reiki healing 3,8% 2,8% 1,2% 2,3% 1,4% 2,3% -1,5 pp (-39,5%) +0,9 pp (+64,3%)
Thought Field Therapy (TFT) - 0,9% - - - - - -

5. How is usage of CAM and supplements developing, gender-wise?

Table 5.1: Male users

% of all men in the survey 2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Total use of CAM 38,7% 43,9% 39,9% 41,6% 40,6% 39,2% +0,5 pp (+1,2%) -1,4 pp (+3,4%)
CAM treatment from providers 35,7% 46,8% 41,0% 40,9% 39,1% 40,2% +4,4 pp (+12,4%) +1,1 pp (+2,8%)
Herbs/ natural remedies (not supplements) 37,7% 40,8% 37,5% 43,6% 49,5% 36,2% -1,5 pp (-3,9%) -13,3 pp (-26,9%)
Self-help techniques 27,4% 29,0% 23,9% 34,3% 36,7% 27,6% +0,3 pp (+1,0%) -9,1 pp (-24,8%)
Supplements (not herbs) 45,4% 50,8% 48,6% 49,4% 51,4% 47,4% +2,0 pp (+4,4%) -4,0 pp (-7,8%)

Table 5.2: Female users

% of all women in the survey 2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Total use of CAM 61,3% 56,1% 60,1% 58,4% 59,4% 60,8% -0,5 pp  (-0,8%) +1,4 pp (+2,4%)
CAM treatment from providers 64,3% 53,2% 59,0% 59,1% 60,9% 59,8% -4,4 pp (-6,9%) -1,1 pp (-1,8%)
Herbs/ natural remedies (not supplements) 62,3% 59,2% 62,5% 56,4% 50,5% 63,8% +1,5 pp (+2,4%)  +13,3 pp (+26,3%)
Self-help techniques 72,6% 71,0% 76,1% 65,7% 63,3% 72,4% -0,2 pp (-0,4%) +9,1 pp (+14,4%)
Supplements (not herbs) 54,6% 49,2% 51,4% 50,6% 48,6% 52,6% -2,0 pp (-3,7%) +4,0 pp (+8,2%)

6. Respondents' self-reported health status 

Table 6.1: Those who use CAM

  2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Good health 77% 77% 77% 78% 74% 71% -6,0 pp (-7,8%) -3,0 pp (+5,4%)
Neither good nor poor 15% 16% 15% 14% 17% 18% +3,0 pp (+20,0%) +1,0 pp (+5,9%)
Poor health 7% 7% 7% 8% 9% 11% +4,0 pp (+57,1%) +2,0 pp (+22,2%)
Don't know/ won't say 1% - 1% - - - - -
Have a long-term (chronic) disease          38% 41% - +3,0 pp (+7,9%)

Table 6.2: Those who don't use CAM 

  2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Good health 81% 84% 82% 82% 79% 78% -3,0 pp (-3,7%) -1,0 pp (-1,3%)
Neither good nor poor 14% 12% 13% 13% 13% 16% -2,0 pp (-14,3%) +3,0 pp (+23,1%)
Poor health 5% 4% 5% 5% 7% 6% +1,0 pp (+20,0%) -1,0 pp (-14,3%)
Don't know/ won't say - - - - 1% - - -
Have a long-term (chronic) disease  - - - - 35% 30% - -5,0 pp (-14,3%)

"-" means no data; there was no question/ answer about this in the specific survey.

7. Users' experiences with CAM

Table 7.1: Users' experiences of positive effects, lack of effect and negative effects

  2012 2014 2016 2018 2020 2022 Change, 2012-22 Change, 2020-22
Experienced positive health effects - - 58% 63% 59% 89% - +30,0 pp (+50,8%)
Experienced no effect - - 41% 32% 31% 10% - -21,0 pp (-67,7%)
Experienced negative health effects (worsening of condition, adverse effects, interactions etc) 2% 2% 4% 7% 6% 5% +3,0 pp (+150%) -1,0 pp (-16,7%)

These were three separate questions. Thus the categories are not mutually exclusive; users may e.g have experienced both positive and negative effects (with the same or different therapies/ from the same or different provider, etc).

"-" means no data; there was no question/ answer about this in the specific survey.

 

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